Disappointingly and once again, the update doesn't allow any analysis because there are no specific details with which to cross-check against our case lists.
Even CIDRAP is heading to the newspapers to try and identify which existing cases have died.
With my arbitrary deadline for emergence of new MERS cases being the 27th of October (this Sunday) only 2-days away, I think its pretty safe to say that there has been no major symptomatic MERS-CoV transmission event associated with the peak assembly period of the Hajj in 2013 (just like there was none in 2012 when MERS-CoV was already in play).
The United Arab Emirates is reportedly not checking pilgrims for symptoms, although they have their own 2-week clock running to monitor for signs and symptoms of new cases of flu-like illness in pilgrims.
Thankfully, there are studies performing actual laboratory testing, although the details remain unclear. Such studies will tell us whether MERS-CoV is among us already, but not causing the serious disease we've become used to associating with the virus.
Dr Jake Dunning (@OutbreakJake) noted on Twitter...
He also went on to say that...@MackayIM We're testing here in London. Trying to raise awareness, but needs to be balanced against more typical local infections e.g. flu.� Dr Jake Dunning (@OutbreakJake) October 22, 2013
@MackayIM We also have an active MERS observational study in UK, ready to recruit willing patients. @ISARIC1 protocol can be used by anyone.
� Dr Jake Dunning (@OutbreakJake) October 22, 2013
ISARIC - the International Severe Acute Respiratory and emerging Infection Consortium- can be read about at http://isaric.tghn.org/about/.
So my next question becomes, have we been watching the emergence of a new endemic human coronavirus? That question is based on a hypothesis that we have a lot more undetected cases and on Dr Ziad Memish's earlier assertion that MERS-CoV cases are already out and about in other countries. Time, and some testing, will tell.
